Background/Purpose:

Psoriatic arthritis (PsA) is an inflammatory arthritis that occurs in about 30% of patients with Psoriasis (Ps). Recently, a new Patient Reported Outcome Measure (PROM), Psoriatic Arthritis Impact of Disease (PsAID) was specifically developed for PsA Patients. The two versions of the PsAID, PsAID-9 and PsAID-12, are scored on a Numeric Rating Scale (NRS) of 0-10. The Minimal Disease Activity (MDA) is a composite outcome measure for PsA patients, which uses the Health Assessment Questionnaire (HAQ) as one criterion. However, the HAQ does not correlate well with measures of disease activity as PsA disease duration increases, and its use in the assessment of disease activity has been questioned.

Our objectives were to 1) validate the PsAID within our patient cohort, 2) determine if the PsAID can replace any of the other PROMs administered in the clinic, and 3) determine if the PsAID can replace the HAQ in the MDA.

Methods:

Patients were recruited from a single psoriatic arthritis clinic. All patients completed the PsAID and 10 other PROMs. Various measures of disease activity were recorded by a physician at each visit. Descriptive statistics (mean, median, SD, min, max) were calculated for all PROMs. PsAID cut-offs for use in the MDA were generated based on Remission (REM) and Low Disease Activity (LDA) disease states in the Clinical Disease Activity for Psoriatic Arthritis Index (cDAPSA).

Results:

115 patients completed the PsAID. There were 70 males, 45 females, with a mean PsA duration of 18.7 (±11.6) years. Mean scores of PsAID-9 and PsAID-12 were 3.4 (±2.4) and 3.2 (±2.3) respectively. The PsAID correlated moderately well with 9 of the PROMs administered in the clinic (R²= 0.51-0.78). Four PsAID cutoffs were generated for use in the MDA: REM PsAID-9, REM PsAID-12, LDA PsAID-9, and LDA PsAID-12. All four versions of the PsAID MDAs had a sensitivity greater than 85% with the HAQ MDA, and three versions of the PsAID MDA had a specificity greater than 85% with the HAQ MDA.

Conclusion:

Our cohort had lower mean PsAID scores than previously reported series suggesting that our patients are monitored carefully. The only moderate correlations with other PROMs suggest that the PSAID cannot replace any of these PROMs. The high sensitivity and specificity of the PsAID MDA with the HAQ MDA suggest that the PsAID is an effective replacement for the HAQ in the MDA.

« Back to 2018 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/a-novel-role-for-the-psoriatic-arthritis-impact-of-disease-questionnaire/